				<form id="client-form">
					<input type="hidden" name="act" id="client_act" value="add" />
					<input type="hidden" name="profile_id" id="client_profile_id" value="-1" />
					<div class="invoice-form-col css_left">
						<div>
							<label for="client_name" class="ui-widget-header ui-corner-left" >Full Name</label>
							<input type="text" name="name" id="client_name" class="ui-input ui-corner-right required">
						</div>
						<div>
							<label for="client_company_name" class="ui-widget-header ui-corner-left" >Company Name</label>
							<input type="text" name="company_name" id="client_company_name" class="ui-input ui-corner-right required">
						</div>
						<div>
							<label for="client_email_address" class="ui-widget-header ui-corner-left" >E-Mail Address</label>
							<input type="text" name="email_address" id="client_email_address" class="ui-input ui-corner-right required">
						</div>
						<div>
							<label for="client_mailing_address" class="ui-widget-header ui-corner-top above" >Mailing Address</label>
							<textarea name="mailing_address" id="client_mailing_address" class="ui-input ui-corner-bottom below required"></textarea>
						</div>
					</div>
				</form>
